Citation Nr: 18149186
Decision Date: 11/08/18	Archive Date: 11/08/18

DOCKET NO. 14-44 176
DATE:	November 8, 2018
REMANDED
Entitlement to service connection for a right thumb disability is remanded.
REASONS FOR REMAND
The Veteran served on active duty from September 1973 to March 1974, and from March 1977 to March 1994. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a January 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran requested a hearing before a Veterans Law Judge (VLJ), but later withdrew the hearing request. 02/12/2018, VA 27-0820 Report of General Information.
Entitlement to service connection for right thumb disability is remanded.
The Veteran contends that his right thumb osteoarthritis is due to in-service injuries. Specifically, the Veteran’s service treatment records indicate that the Veteran was treated in October 1976 for a right thumb injury incurred while playing football. 07/21/2014, STR – Medical, page 5. The Veteran was also treated in September 1991 for a right thumb injury incurred from blunt trauma. 07/21/2014, STR – Medical, page 48. 
The Veteran was afforded a VA examination in February 2014, during which the Veteran was diagnosed with osteoarthritis in his right thumb. The examiner noted the Veteran’s in-service injuries occurring on October 1976 and September 1991. The examiner opined that the Veteran’s current right thumb disability is less likely than not caused by the in-service injuries, stating that the Veteran’s arthritic changes in the right thumb is a disease of wear and tear, and that the in-service injuries were adequately treated and resolved. 
However, the Veteran contends that his right thumb osteoarthritis may have manifested in a form of post-traumatic arthritis that can have its onset decades after an injury or trauma to a joint, and suggested that further development may be needed to address this issue; to this effect, the Veteran provided URLs for two online articles regarding post-traumatic arthritis. 10/03/2018, Appellate Brief. Accordingly, upon review of the February 2014 examination, the Board finds the medical opinion to be inadequate, as it does not specifically address post-traumatic arthritis. Thus, the Board finds that an additional addendum opinion to the February 2014 VA examination is necessary to adjudicate this issue, to include an opinion on whether the Veteran’s right thumb osteoarthritis is in the form of post-traumatic arthritis. 
This matter is REMANDED for the following action:
Obtain an addendum opinion from an appropriate clinician regarding nature and etiology of all current right thumb disability. An in-person examination is not required unless deemed necessary by the clinician. The clinician should review the virtual file, including a copy of this Remand, as well as online articles provided by the Veteran regarding post-traumatic arthritis. The examiner is to address:
For each current right thumb disability, is it at least as likely as not (probability of 50 percent or more) related to an event, disease, or injury in service? **Note: The Veteran’s service treatment records reflect right thumb injuries in October 1976 and September 1991. The examiner is asked to provide a comprehensive rationale for any opinion offered, including whether the Veteran’s right thumb osteoarthritis is in the form of post-traumatic arthritis. The examiner must consider lay reports from the Veteran along with pertinent medical evidence, including medical literature submitted by him. If the examiner cannot offer an opinion without resort to speculation, he or she should explain why and state what additional evidence, if any, would be required to offer an opinion.
 
 
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	D. Han, Associate Counsel